title: Cardiovascular collapse following povidone-iodine wash.
abstract: We present a case study of a severe episode of iodine toxicity following povidone-iodine wash with clinical manifestations of cardiovascular collapse, metabolic acidosis, renal failure and seizures. Povidone-iodine has been used as a medical antiseptic and disinfectant since 1952 Iodine toxicity secondary to povidone-iodine use is rare. Iodine toxicity is difficult to diagnose and the diagnosis is made by a high index of suspicion. Toxicity due to iodine correlates with serum and urine iodine levels. Treatment of iodine toxicity is supportive. A review of literature relating to the components of povidone-iodine, iodine metabolism, its manifestations and management of iodine toxicity secondary to povidone-iodine is also presented. An Ovid-Medline search from 1950 to 2009 revealed 1236 articles on the clinical manifestations of povidone-iodine usage but no article on iodine toxicity relating to povidone-iodine based on the following search criteria: povidone-iodine and/or iodine toxicity secondary to povidone-iodine (limited to English language, review articles, full text and human patients).
authors.affiliation: Intensive Care Unit, Prince of Wales Hospital, Sydney, New South Wales, Australia. rkhariharan@hotmail.com
authors.forename: H
authors.initials: H
authors.lastname: Ramaswamykanive
authors.forename: Z
authors.initials: Z
authors.lastname: Nanavati
authors.forename: J
authors.initials: J
authors.lastname: Mackie
authors.forename: R
authors.initials: R
authors.lastname: Linderman
authors.forename: O
authors.initials: O
authors.lastname: Lavee
mesh_terms: D000138:Acidosis / Q000139:chemically induced* / Q000628:therapy; D000368:Aged; D000891:Anti-Infective Agents, Local / Q000009:adverse effects* / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D004232:Diuretics / Q000008:administration & dosage; D005440:Fluid Therapy; D005500:Follow-Up Studies; D005665:Furosemide / Q000008:administration & dosage; D006323:Heart Arrest / Q000139:chemically induced* / Q000628:therapy; D017583:Hemodiafiltration; D006801:Humans; D007455:Iodine / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D011206:Povidone-Iodine / Q000009:adverse effects* / Q000627:therapeutic use; D051437:Renal Insufficiency / Q000139:chemically induced* / Q000628:therapy; D012640:Seizures / Q000139:chemically induced* / Q000188:drug therapy; D007507:Therapeutic Irrigation / Q000009:adverse effects / Q000379:methods
chemical_list: D000891:Anti-Infective Agents, Local; D000927:Anticonvulsants; D004232:Diuretics; D005665:Furosemide; D011206:Povidone-Iodine; D007455:Iodine